| Doctor Name: | HEATHER KING |
| NPI Number: | 1164895371 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 4208 |
| Business Practice Address: | 486 W 1st Ave Glenns Ferry, ID - 836232701 |
| Business Phone Number: | 2083667416 |
| Business Fax Number: | 2083662717 |
| Mailing Address: | Po Box 266, GLENNS FERRY |
| State: | ID |
| Postal Code: | 836230266 |
| Phone Number: | 2083667416 |
| Fax Number: | 2083662595 |
| NPI Enumeration Date: | 11/10/2015 |
| NPI Last Update Date: | 11/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4208 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |